Provider Demographics
NPI:1780129817
Name:GONZALES-ESTRADA, JOVANY (CFY-SLP)
Entity type:Individual
Prefix:MR
First Name:JOVANY
Middle Name:
Last Name:GONZALES-ESTRADA
Suffix:
Gender:M
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 COLLEGE ST
Mailing Address - Street 2:# E
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695
Mailing Address - Country:US
Mailing Address - Phone:530-668-1010
Mailing Address - Fax:530-668-9799
Practice Address - Street 1:1321 COLLEGE ST
Practice Address - Street 2:# E
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695
Practice Address - Country:US
Practice Address - Phone:530-668-1010
Practice Address - Fax:530-668-9799
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist